P-glycoprotein (P-gp), a member of the ATP-binding cassette (ABC) family of transporters, plays a crucial role in the development of multi-drug resistance (MDR) in cancer treatment. P-gp actively pumps chemotherapeutic drugs out of cancer cells, reducing their intracellular concentrations and thereby diminishing their efficacy. This review explores the mechanisms by which P-gp contributes to MDR, including intrinsic and acquired resistance. It also discusses various strategies to inhibit P-gp, such as blocking drug binding sites, interfering with ATP hydrolysis, and altering cell membrane integrity. The potential of fourth-generation P-gp inhibitors and other novel approaches to enhance the effectiveness of cancer therapies is also examined. Understanding and overcoming P-gp-mediated MDR is essential for improving therapeutic outcomes in cancer patients.
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